Risk of discontinuation of clopidogrel after 1 month following baremetal stents: A propensity-score adjusted comparison with continued administration of clopidogrel after drug-eluting stents
Journal of Thrombosis and Thrombolysis, ISSN: 1573-742X, Vol: 45, Issue: 3, Page: 432-439
2018
- 2Citations
- 27Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations2
- Citation Indexes2
- CrossRef1
- Captures27
- Readers27
- 27
Article Description
In patients at high risk for bleeding undergoing percutaneous coronary intervention (PCI) the use of bare-metal-stent (BMS) is considered an option that allows discontinuation of clopidogrel after 4 weeks. We sought to investigate the risk of early discontinuation of clopidogrel in patients with BMS as compared with a 6-month course of clopidogrel after DES in patients with or without high on-treatment platelet reactivity (HTPR). In 765 consecutive patients undergoing PCI after loading with clopidogrel 600 mg, HTPR was tested by optical aggregometry and defined as residual platelet reactivity > 14%. On top of aspirin 100 mg, patients received clopidogrel 75 mg for 4 weeks after BMS or 6 months after DES. The primary endpoint was all-cause mortality or myocardial infarction (MI) during 1 year. The 1-year incidence of death or MI was 3.5% with BMS (n = 484), 0.9% with DES and no HTPR (n = 211), and 7.1% with DES and HTPR (n = 70; p = 0.03). Landmark analyses for the first 6 months demonstrated that the risk of patients receiving BMS was similar as in patients receiving a DES with HTPR during this period (2.3 vs. 2.9%) but lowest in patients receiving a DES without HTPR (0.5%). The incidence of bleeding was similar in all three groups. These findings did not change after propensity score adjustment for stent type. After discontinuation of clopidogrel at 1 month, patients treated with BMS are at higher risk for death or MI than patients treated with a DES and sufficiently responding to clopidogrel planned for 6 months.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85040785017&origin=inward; http://dx.doi.org/10.1007/s11239-018-1613-6; http://www.ncbi.nlm.nih.gov/pubmed/29349545; https://clinicaltrials.gov/ct2/show/NCT00457236; https://link.springer.com/10.1007/s11239-018-1613-6; https://dx.doi.org/10.1007/s11239-018-1613-6; https://link.springer.com/article/10.1007/s11239-018-1613-6
Springer Science and Business Media LLC
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